AbstractBackground: Although many patients have recovered from COVID-19, it is important to remember that long-term complications may occur after recovery. One of these complications is avascular bone necrosis. There is limited literature regarding multiple bone avascular necrosis due to micro thrombi in a patient recovering from COVID-19.
Case Presentation: We present here a 25-year-old patient with chief complaints of pain in the right knee and hip since 3 and a half months. MRI of the knee and hip revealed intramedullary infarcts in the distal femur and proximal tibia and bilateral hip AVN. After a gap of few weeks the patient also developed pain in his right shoulder, and from this point he was advised for an MRI of the shoulder, which revealed involvement of both humeral heads. He was a non-alcoholic and non-smoker with no significant past medical history except for bilateral severe pneumonia related to COVID-19, 3 years ago in 2020, for which he was hospitalized and underwent treatment with complete recovery. Taking into account all the radiological and laboratory examinations and as per the history, there is a very strong predilection of the development of AVN with microthrombi due to an inflammatory process that links them to the infection of COVID 19. As this can result in long-term morbidity, AVN of bone can be considered as one of the of the most harmful effects after infection with COVID-19.
